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Analysis & Opinion
07.11.11 Anti-Pro-Choice
By Svetlana Kononova

Following a third reading, the State Duma has approved a draft law “On the Foundations of Healthcare for Russian Citizens,” which will come into force at the beginning of 2012. But medical experts and representatives of human rights organizations warn that the more controversial section of the law, which aims to reduce the number of abortions in Russia, could have serious consequences for Russian women’s health.

Doctor Lyubov Erofeeva, the general director of the Russian Association for Population and Development (RAPD) and a cofounder of the “Rowen Bunch: For Reproductive Choice” coalition, said two amendments will limit women's access to abortions and may force them to resort to illegal and unsafe procedures. The first amendment establishes the doctor's right to refuse to carry out an abortion due to his or her religious beliefs. “This practice exists in some European countries and is very well regulated. Information about doctors who never perform abortions for religious or other reasons is available to the public. It is published on the clinics' Web sites,” said Erofeeva. Women can thus easily choose a different doctor or clinic. “But in Russia, doctors at state clinics might use this right to refuse to carry out an abortion for free, and thus make a profit. They may advise patients to go to a commercial clinic around the corner and then get kickbacks,” she said.

The second controversial amendment is the introduction of a waiting period. Under current Russian legislation, women can have an abortion upon request up until the 12th week of pregnancy. Between 12 and 22 weeks, an abortion can be carried out if a case meets certain medical or social criteria laid out by the government. But under the new draft law, women will have to wait for a week after they ask for an abortion (or for 48 hours between the fourth and the seventh weeks and after 11 weeks of pregnancy) – they will be obliged to go through biased pre-abortion counseling, which may include psychological consultations, ultrasound pictures of their baby and listening to the fetal heartbeat.

“Most abortions in Russia are carried out on married women aged 25 to 35 who already have children. They do it not because they are thoughtless or don't know about the possible consequences of having an abortion. They simply can't afford to raise more children. If a couple plans to have two children, they will never give birth to five or seven. So this waiting time will not change a woman's decision,” said Erofeeva. She also said that forcing women who have an irregular menstrual cycle to wait for an abortion could mean that they miss the timeframe in which they could have a safer, medication-induced abortion. “The authors of the draft said that introducing this waiting time will decrease the number of abortions by 20 percent. Maybe 20 percent of women who want to have an abortion will run out of time and be forced to give birth. This law will primarily hit uneducated women with low incomes who live in the provinces and have limited access to medical care. They will be forced to travel to the clinic in the nearest town several times,” Erofeeva said. She also stressed that no other country in Europe has a pre-abortion waiting period of as long as seven days. “Lawmakers are trying to plunge the country into a dangerous experiment,” she said.

Members of the “Free Motherhood: Let’s Fight Abortions but not Women!” group called the waiting period “outrageous and unacceptable.” “From a moral and legal point of view, this measure sets a precedent of state interference in privacy, in the questions of personal choice. In fact, it is an attack on freedom of conscience and on private life. Secondly, it is a distinctly anti-female measure, because lawmakers believe that women can’t make a considered decision on their own, without pressure from the lawmakers,” said Nikolai Vinnik, a member of the group. “In terms of healthcare, it is a dangerous measure. The availability of women’s health clinics in Russia is catastrophically low. Even in big cities, women often have to wait for a doctor’s appointment for two weeks. Another problem is the distance to the nearest clinic. During the first six months of this year, 64 newborns were killed by their mothers – this statistic reflects the poor availability of abortions in Russia. If so many people don’t have access to a timely legal abortion service now, what will happen after additional restrictions are implemented?” Vinnik asked. “Implementing this waiting period may lead to growth in infanticide, complications after abortions, criminal abortions and an increased death rate. Moreover, this measure is not effective. Both global and domestic experience shows that restrictions don’t significantly influence the number of abortions. There is not a country in the world where introducing a waiting period has had a positive effect.”

Members of Vinnik’s group believe that there are a number of alternative measures that would really work and could decrease the number of abortions. These methods are well-known from international experience. “Firstly, it is necessary to inform people, including teenagers, about contraception. Sexual education in schools decreases the number of teenage pregnancies and sexually-transmitted diseases, and in the long-term, the number of abortions in the country. Now people in Russia get their information about contraception mostly from the manufacturers’ advertising, which is not always objective,” said Vera Akulova, another activist of the movement. “Secondly, information itself doesn’t help if people can’t afford contraception. So it is necessary to make contraception available – cheap or even free – to vulnerable groups,” Akulova continued. “Thirdly, statistics show that the number of repeat abortions in our country is very high. Some women know about contraception and can afford it, but they may have an abortion once in their lifetime in an emergency situation (no contraception has a 100-percent success rate). Many women never experience an unwanted pregnancy. But there are women who have three, four or even more abortions. These women need psychological support and help them choose a secure contraception strategy that suits their personal life and financial circumstances. Even simple, post-abortion consultations about different methods of contraception reduce the number of repeat abortions by half! It is a very cheap and effective measure,” Akulova said.

Igor Yanovich, a member of the “Rowen Bunch,” also said that in some cases unwanted pregnancies are the result of coercion. “Often husbands or partners compel women to get pregnant against their will, or force them to have an abortion even if they want children. Therefore psychologists in women’s health clinics should not put any pressure on patients, but try to help them escape domestic violence,” he said.
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